MR. ELLIS R JACKSON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1659362283
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,710 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in GA
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Provider Addresses for MR. ELLIS R JACKSON (CRNA)
610, 3rd Street, Macon, Bibb County, Georgia, 31201, United States
MACON, GA 312013294
Phone: (229) 344-6080
Fax: (229) 436-8649
Type: Location
427 FUSSELL RD
LEESBURG, GA 317635210
Phone: (229) 344-6080
Fax: (229) 436-8649
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $14.
Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.
Last reported payment date: 2023-08-03 • Largest payer in this snapshot: Medtronic, Inc. ($14).
Total Amount
$14
General + Research + Ownership
Payments
1
Total payment records
General Amount
$14
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-08-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-08-31 (1012 days ago).
Enrollment records
1
Earliest due date
2023-08-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040823000699 | I | Certified Registered Nurse Anesthetist (Crna) | GA | 2023-08-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 76 | 76 | $0 |
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 64 | 61 | $0 |
| 00812 | Anesthesia for exam of colon using an endoscope | 45 | 45 | $0 |
| 00813 | Anesthesia for procedure on small and large bowel using an endoscope | 41 | 41 | $0 |
Insurance plans in this area (ZIP 31201)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | GA |
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